Health Belief Model

1. Health Belief Model Perceived Susceptibility Perceived Severity I’m safe – I only have “clean” partners. Having an STD might really affect me… Harlem Health Promotion Center/Center for Community Health and Education

2. Health Belief Model COST Long wait Breaking up Embarrassment BENEFIT Condoms = safety Respect for honesty Last longer

3. Cue to Action

4. Theory of Reasoned Action Beliefs about behavior Attitude toward behavior Normative beliefs about BehaviorSubjective Norm Intention

5. Normative Pressure ? “Sex and condoms are immoral!” You should always use a condom – it’s the only way to be safe! “Come on baby, we don’t need condoms.” Harlem Health Promotion Center/Center for Community Health and Education

6. Social Cognitive Theory I know I can do it…! Harlem Health Promotion Center/Center for Community Health and Education

7. Consensus Model: key ingredients of BEHAVIOR CHANGE • Intention • Absence of environmental constraints • Necessary skills • Benefits outweigh costs • Social support • Self-efficacy • Consistent with self-standards • Positive affect Harlem Health Promotion Center/Center for Community Health and Education

8. Intention “I will ask my boyfriend to use a condom every time we have sexual intercourse.” Harlem Health Promotion Center/Center for Community Health and Education

9. Absence of environmental constraints “I can get condoms at the pharmacy.” Harlem Health Promotion Center/Center for Community Health and Education

10. Skills “I know how to use a condom.” Harlem Health Promotion Center/Center for Community Health and Education

11. Positive Attitude (benefits outweigh costs) “Using a condom every time I have sex is a good thing to do.” Harlem Health Promotion Center/Center for Community Health and Education

12. Perceived norms “Most people who are important to me think I should use condoms.” Harlem Health Promotion Center/Center for Community Health and Education

13. Self-efficacy (confidence) “Even though my boyfriend doesn’t like condoms, I’m confident I can get him to use them every time.” Harlem Health Promotion Center/Center for Community Health and Education

14. Self-standards “‘Real men’ always uses condoms when they have intercourse.” Harlem Health Promotion Center/Center for Community Health and Education

15. Emotional reactions “When I think of using a condom, I feel anxious…” How easily the same task becomes difficult because ideas, beliefs, fears all impinge on performance, disrupting even those goals strongly desired.” --Milton Erickson, MD

16. “Stages of Change” Model (change is an ongoing process) • Precontemplation • Contemplation • Preparation • Action • Maintenance “Habit is habit, and not to be flung out of the window, but coaxed down the stairs a step at a time” --Mark Twain